1/41. Peripheral ulcerative keratitis 'corneal melt' and rheumatoid arthritis: a case series.OBJECTIVES: (1) To review the visual and systemic outcomes of patients who developed rheumatoid arthritis (RA)-associated peripheral ulcerative keratitis (PUK). (2) To describe the clinical and serological characteristics of the patients' arthropathy at the time of presentation of this rare condition. (3) To review the aetiology and management of RA-associated PUK. patients and methods. A case series is given of all nine patients within our unit who have developed RA-associated PUK since 1996. Details of the patients' arthropathy and the serological characteristics of the RA at presentation of PUK were noted. The patients' visual outcomes and the development of any significant systemic complications were recorded. RESULTS: All patients had long-standing seropositive, erosive RA. PUK was associated with a poor visual outcome in most patients, five requiring emergency corneal surgery to prevent perforation of the globe. Two patients developed systemic vasculitis within 1 month of PUK onset, one of whom died. CONCLUSION: RA-associated PUK often has a poor visual outcome and its appearance may herald the transformation of a patient's RA into the systemic vasculitic phase. RA-associated PUK should be managed with aggressive immunosuppression if the associated morbidity and mortality are to be avoided. Cell-mediated mechanisms appear to be important in the aetiopathogenesis of PUK and a combination of corticosteroids and cyclosporin is therefore probably the regimen of choice.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
2/41. Non-steroidal anti-inflammatory drugs as a possible cause for reversible infertility.OBJECTIVE: To highlight the possible association between infertility and treatment with long-term non-steroidal anti-inflammatory drug (NSAIDs). NSAIDs act mainly through the inhibition of cyclooxygenase, the enzyme that catalyses the synthesis of prostaglandins, which are essential mediators of ovulation, implantation and placentation of the conceptus. methods: case reports of four women suffering from severe arthritis, on long-term NSAIDs and undergoing extensive investigation and treatment for infertility. RESULTS: During the last 2 yr, four out of five women with severe arthritis and difficulty conceiving were counselled to stop NSAIDs, and they successfully conceived shortly after the withdrawal of NSAIDs. CONCLUSION: NSAIDs, used largely for the treatment of rheumatological conditions, may be responsible for some cases of infertility.- - - - - - - - - - ranking = 1.6941900023366keywords = gland (Clic here for more details about this article) |
3/41. Thoracoscopic resection of the pulmonary aspergilloma: report of two cases.Pulmonary aspergillomas causing hemoptysis were successfully resected through videothoracoscopy in two cases. We removed an aspergilloma located in the right lower lobe of the lung in a 48-year-old woman with a bronchial cyst and rheumatoid arthritis. We also removed an aspergilloma located in the left upper lobe of the lung in a 59-year-old man with emphysematous bullae and diabetes mellitus. In both cases, the aspergillomas were removed by pulmonary wedge resection through scheduled thoracoscopy.- - - - - - - - - - ranking = 2keywords = lobe (Clic here for more details about this article) |
4/41. Painless thyroiditis associated with severe inflammatory reactions in amyloid goiter: a case report.We report the case of a 64-year-old woman with rheumatoid arthritis (RA) associated with high grade fever, malaise, and painless swelling of thyroid gland. Laboratory findings showed severe systemic inflammatory reactions, including increases in various cytokines such as IL-6. gallium-67 citrate imaging revealed intense uptake in the painlessly enlarged thyroid gland. Histologically, biopsied specimens of thyroid showed diffuse amyloid infiltrations, which included amyloid A (AA) protein. Biopsies of rectum and stomach revealed similar amyloid depositions, indicating that the amyloid had a secondary origin, potentially due to RA. All clinical symptoms were relieved by intravenous pulsatile administration of methylprednisolone followed by oral prednisone, resulting in prolonged hypothyroid status. To our knowledge, this is the first case report in japan describing painless thyroiditis with severe inflammatory reactions in amyloid goiter.- - - - - - - - - - ranking = 3.3883800046732keywords = gland (Clic here for more details about this article) |
5/41. Hashimoto's encephalopathy: documentation of mesial temporal seizure origin by ictal EEG.Hashimoto's encephalopathy is a chronic relapsing and remitting encephalopathy associated with antithyroid antibodies. seizures are a frequent manifestation, but are not well characterized in the literature with respect to their onset. We describe a 48-year-old patient with recurrent encephalopathy and seizures, and elevated antithyroid antibodies. One seizure was documented with video-EEG monitoring using scalp and sphenoidal electrodes. The ictal discharge originated in the left mesial-basal temporal region. MRI showed an increased T2 signal in the white matter of the centrum semiovale, but no temporal pathology. Symptoms resolved after treatment with prednisone and azathioprine. Hashimoto's encephalopathy should be considered in patients with unexplained encephalopathy and seizures, including those originating in the temporal lobe.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
6/41. Multiple occlusive retinal arteritis in both eyes of a patient with rheumatoid arthritis.PURPOSE: To report multiple occlusive retinal arteritis as a complication of rheumatoid arthritis. CASE: A 67-year-old woman developed superotemporal branch retinal artery occlusion in both eyes, together with arterial sheathing and large cotton wool patches around the optic disc, in the course of rheumatoid arthritis with moderate activity. OBSERVATIONS: fluorescein angiography disclosed delayed filling of the superotemporal retinal artery in the right eye and no filling of the superotemporal artery in the left eye. In addition, segmental absence of filling was found in peripheral branches of the other major retinal arteries in both eyes. After hyperbaric oxygen therapy and intravenous administration of prostaglandin E1 and urokinase for 2 weeks, there was improvement in her vision. CONCLUSION: Multiple occlusive retinal arteritis in rheumatoid arthritis can manifest as retinal artery occlusion. Rheumatoid arthritis should be included in the differential diagnosis of bilateral retinal artery occlusion.- - - - - - - - - - ranking = 1.6941900023366keywords = gland (Clic here for more details about this article) |
7/41. The supratrochlear lymph nodes: their diagnostic significance in a swollen elbow joint.In the differential diagnosis of a swollen elbow, the palpation of the supratrochlear glands is useful. They are not enlarged in a traumatic elbow joint. They are enlarged, discrete and shotty in rheumatoid arthritis. In tuberculosis, they are enlarged, matted and they may caseate and form a cold abscess on the medial aspect of the supratrochlear region of the arm.- - - - - - - - - - ranking = 1.6941900023366keywords = gland (Clic here for more details about this article) |
8/41. Spontaneous external auditory canal cholesteatoma complicated by rheumatoid arthritis--case report and review of the literature.A 63-year-old woman with rheumatoid arthritis sought medical assistance for dull and chronic pain in her left ear two and half years after her initial diagnostic examination. Otoscopic examination revealed that the posteroinferior wall of the bony external ear canal was eroded and that the small cavity was filled with squamous debris. The condition was diagnosed as external auditory canal cholesteatoma (EACC). The existence of EACC might suggest complications of bone disease, aging cerumen gland, or a low migratory rate of the epithelium.- - - - - - - - - - ranking = 1.6941900023366keywords = gland (Clic here for more details about this article) |
9/41. Gigantomastia induced by bucillamine.Drug-induced mammary hyperplasias have been reported as rare complications of D-penicillamine and Neothetazone. The authors report the first case of bucillamine-induced giant mammary hyperplasia. Bucillamine is used as an antirheumatic drug that is structurally analogous to D-penicillamine. A 25-year-old woman with rheumatoid arthritis for the past 5 years started to develop gradual enlargement of her breasts 15 months before presentation. She had been on a combined treatment of steroid and lobenzarit disodium for the first 3 years, and then continued with a combined treatment of steroid and bucillamine for the following years until she was found to have pulmonary tuberculosis, at which time the steroid was suspended 10 months before she visited the authors' clinic. An almost total breast reduction was performed; 5 kg of right breast tissue and 7 kg of left breast tissue were excised. Retrospectively, bucillamine was believed to be the cause of the giant hypertrophy because of its structural similarity to D-penicillamine, which was the subject of an abundance of reports of mammary hyperplasia.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
10/41. Lymphoepithelioma-like carcinoma of the parotid gland in a patient with rheumatoid arthritis.Lymphoepithelioma-like carcinoma (LELC) is an Epstein-Barr virus (EBV) related malignancy. It is not a common condition and is usually found in the head and neck region. We describe the development of LELC involving the parotid gland in a patient with rheumatoid arthritis (RA) who had been receiving long-term azathioprine. A brief review is also made on the clinical presentation and histological features of LELC and the association of RA with EBV related diseases. The latter may be attributed to an increase in risk of malignancy associated with RA or as a result of the long-term immunosuppressive used.- - - - - - - - - - ranking = 8.470950011683keywords = gland (Clic here for more details about this article) |
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